Related Experiment Video

Updated: Apr 20, 2026

Author Spotlight: Enhancing Coronary Artery Revascularization
05:25

Author Spotlight: Enhancing Coronary Artery Revascularization

Published on: September 15, 2023

1.4K

Short, Intermediate and long term outcomes of CABG vs. PCI with DES in Patients With Multivessel Coronary Artery

Zaher Fanari1, Sandra A Weiss1, Wei Zhang2

  • 1Section of Cardiology, Christiana Care Health System, Newark, DE.

The European Journal of Cardiovascular Medicine
|November 21, 2014
PubMed

Insights

Percutaneous coronary intervention (PCI) with drug-eluting stents (DES) showed similar death and heart attack rates to bypass surgery (CABG) at 1-2 years. However, at 5 years, PCI with DES was linked to increased death and heart attack risks in multivessel coronary artery disease.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Clinical Trials

Background:

  • Percutaneous coronary intervention (PCI) and Coronary Artery Bypass Grafting (CABG) are primary revascularization methods for ischemic heart disease.
  • Numerous randomized controlled trials (RCTs) have evaluated PCI versus CABG in patients with multivessel coronary artery disease (CAD).

Purpose of the Study:

  • To compare the long-term outcomes of PCI using drug-eluting stents (DES) versus CABG in patients with multivessel CAD.
  • To analyze data from contemporary RCTs to assess the effectiveness and safety of these revascularization strategies.

Main Methods:

  • A meta-analysis was conducted using data from six RCTs.
  • Outcomes were compared between PCI with DES and CABG at 1-year, 2-year, and 5-year follow-up points.

Main Results:

  • At 1 year, PCI with DES showed higher rates of target vessel revascularization (TVR) but lower rates of stroke compared to CABG. No significant differences were observed in death or myocardial infarction (MI) rates.
  • At 5 years, PCI with DES was associated with a significantly higher incidence of both death and MI compared to CABG.
  • Increased MI risk with PCI was observed in both diabetic and non-diabetic patients, while increased death risk was primarily noted in diabetic patients.

Conclusions:

  • PCI with DES demonstrates comparable rates of death and MI to CABG at 1 and 2 years in patients with multivessel CAD.
  • Long-term follow-up (5 years) indicates that PCI with DES is associated with an increased risk of death and MI compared to CABG.
  • The findings suggest careful consideration of revascularization strategy based on patient-specific factors, particularly in diabetic individuals.
Abstract

Keywords:
Coronary Artery Bypass GraftingDrug Eluting StentsMeta-AnalysisPercutaneous coronary interventionRandomized Control Trials

More Related Videos

A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis04:30

A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis

Published on: May 14, 2013

26.6K

Related Concept Videos

Coronary Artery Disease V: Interprofessional Care01:27

Coronary Artery Disease V: Interprofessional Care

Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
437
Peripheral Artery Disease III: Interprofessional Care01:27

Peripheral Artery Disease III: Interprofessional Care

Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
634
Acute Coronary Syndrome IV: Interprofessional Care01:28

Acute Coronary Syndrome IV: Interprofessional Care

IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
503
Peripheral Artery Disease V: Postoperative Nursing Management01:23

Peripheral Artery Disease V: Postoperative Nursing Management

During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
610
Angina IV: Management01:26

Angina IV: Management

IntroductionThe management of angina requires a comprehensive approach that includes pharmacological therapies, medical procedures, and lifestyle modifications.Pharmacological TherapiesAntiplatelet agents, such as aspirin, clopidogrel, prasugrel, and ticagrelor, play a pivotal role in preventing thrombus formation in patients with angina. These medications inhibit platelet aggregation and reduce the likelihood of myocardial infarction and other cardiovascular events.Anticoagulants, including...
461
Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
484